Should we continue letting the “ludicrously dishonest” (well stated Avik Roy) presumptions of the ACA shape the future of our healthcare delivery system?

I think not.

Prior to the ACA, 6 states (Maine, Massachusetts, New Jersey, New York, Vermont and Washington) required guaranteed issue individual plans. In 2010 these states had some of the highest individual insurance rates in the country:

There were another 35 states that offered guaranteed issue high risk pools:

That means 41 states already had access to guaranteed issue individual health insurance plans prior to the ACA.

Here’s another point… around my part of the country (KS / MO) the guaranteed issue plans available prior to the ACA were less expensive than the non-subsidized 2017 individual plans!

ACA proponents are quick to point out that there are more people insured now than prior to the ACA. What they fail to mention is that most of those gains are from new Medicaid enrollments (15 million) vs. state or federal Marketplaces (11 million):

Include Price Transparency legislation letting patients know up front what tests and procedures will cost

And since health insurance does not equal health care, there needs to be fundamental changes to physician access:

Direct Primary Care’s (DPC) monthly membership fees should be allowed as an eligible HSA / FSA / HRA expense (are you surprised I made it this far before mentioning HSA?)

States should be given block grants to explore more effective health care delivery systems (i.e. HSA & DPC) for Medicaid, Medicare, and VA

Allowing healthy Americans to purchase underwritten health insurance plans at substantially lower rates has been called discrimination by some. That is true. Insurance companies discriminate.

What would happen to auto insurance rates if everyone paid the same regardless of driving records or previous accidents? Most would pay substantially higher, some would pay less.

What would happen to life insurance rates if everyone paid the same regardless of weight / tobacco use / health issues? Most would pay more, some would pay less.

Providing access to high risk individual insurance plans for the few that need it while allowing healthy individuals to purchase lower cost underwritten plans would make individual health insurance affordable again.

According to dictionary.com, affordable means, “believed to be within one’s financial means.” Obviously the politicians in Washington took this definition literally when they passed the Affordable Care Act.

According to an article in Forbes this past week, individual health insurance premiums will increase by an average of 41% across the country. Offering subsidies to a small subset of Americans to help offset substantially higher rates for everyone else doesn’t make sense. However by this definition, all they needed to do was to make health insurance within one’sfinancial means. And as of yesterday we know at least 5 have enrolled so far.

The Manhattan Institute put together an excellent interactive map that shows pre and post ObamaCare rates for each state:

Manhattan Institute – Know Your Rates

There are winners and losers in ObamaCare.

Winners: unhealthy people that were forced into expensive state pool guaranteed issue health plans that can now get any plan they choose without proof of insurabilityWinners: low wage earners that qualify for expanded Medicaid or a substantial premium subsidy (and actually make it through healthcare.gov)

Losers: everyone else

I guess it all depends on what your definition of the word “Affordable” is…

While talking about healthcare reform with my wife, our teenage son started asking questions. We tried to answer him in a way he could understand, but we just weren’t getting through. Health insurance is a foreign language to him. However he is dreaming about which car he will soon purchase. So we introduced ObamaCare to him by way of the Affordable Car Act… a.k.a. Obama-Car:

Yes, these OPTIONS are nice if you have the money to pay for them, but they should remain OPTIONS, not REQUIREMENTS.

Instead of a Chevy Cruze starting at $17,000 the new Obama-Car compliant version (such as the Chevy Volt) would be priced around $34,000.

Obama claims these new cars will only be paid in full by the “millionaires and billionaires” because anyone making less than 400% of the poverty level will have some (or all) of their car subsidized by the government.

Now let’s talk about used cars…

Let’s say you like your existing car. As long as you owned it before March 23, 2010, you would be allowed to keep it. You cannot make any changes to it or it would no longer be “grandfathered” and you would be forced into buying a new Obama-Car next year or pay a penalty.

If it doesn’t get good enough gas mileage or include all the new Obama-Car required Overpriced Bureaucratically Authorized Mandated Add-ons (OBAMA), then you would also be penalized.

Our son is glad Obama-Car doesn’t exist. He can save his own money to purchase any car he chooses… as long as Dad (not Obama) approves of it!

Dislaimer: This article was never meant to suggest Obama-Car legislation is needed or should ever become law.

We have assembled several calculators available today that can help make preparing for 2014 much easier.

Although the employer mandate has been postponed until 2015, the individual mandate still applies. Anyone not covered by Minimum Essential Coverage next year could be subject to a penalty tax of the greater of $95 per uninsured or 1% of household over the filing threshold:

All new health insurance plans will be guaranteed issue and required to include essential health benefits which will greatly increase premiums. The Public Exchanges (both state and federal) are to be open in October. People making less than 400% of poverty level could be eligible for subsidized health insurance plans if they are purchased on the State / Federal Exchanges. It is estimated that 26 million should be eligible for these subsidies, however only 6 million are estimated to enroll in 2014. Here is a calculator to see if you would be eligible for a subsidy:

Small businesses with less than 25 employees that earn less than $50,000 average annual salary and pay at least 50% of their health insurance premiums could also qualify for a small business tax credit. For 2014 the tax credit is only available if the plan is purchased through the Small Business Health Options Program (SHOP) Marketplace:

Don’t wait until it’s too late. If you are relatively healthy, you could save money by applying now BEFORE all plans are guaranteed issue and are weighed down with expensive government mandated benefits next year.

Or you can call an independent health insurance agent at 913-432-2732.

Although the employer mandate has been delayed 12 months, businesses are still concerned about how to minimize (or eliminate) their exposure in 2015. This calculator helps calculate how many full time equivalent (FTE) employees you have and what your potential penalty might be if/when the employer mandate is reinstated:

What Is An HSA?

A Health Savings Account (HSA) is a tax-deductible account to which you can contribute to save for future medical expenses or to pay for any day-to-day, qualified medical expenses permitted under federal tax law...[More]

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